title: A pediatric bone mass scan has poor ability to predict adult bone mass: a 28-year prospective study in 214 children.
abstract: As the correlation of bone mass from childhood to adulthood is unclear, we conducted a long-term prospective observational study to determine if a pediatric bone mass scan could predict adult bone mass. We measured cortical bone mineral content (BMC [g]), bone mineral density (BMD [g/cm(2)]), and bone width (cm) in the distal forearm by single photon absorptiometry in 120 boys and 94 girls with a mean age of 10 years (range 3-17) and mean 28 years (range 25-29) later. We calculated individual and age-specific bone mass Z scores, using the control cohort included at baseline as reference, and evaluated correlations between the two measurements with Pearson's correlation coefficient. Individual Z scores were also stratified in quartiles to register movements between quartiles from growth to adulthood. BMD Z scores in childhood and adulthood correlated in both boys (r = 0.35, p < 0.0001) and girls (r = 0.50, p < 0.0001) and in both children ≥10 years at baseline (boys r = 0.43 and girls r = 0.58, both p < 0.0001) and children <10 years at baseline (boys r = 0.26 and girls r = 0.40, both p < 0.05). Of the children in the lowest quartile of BMD, 58% had left the lowest quartile in adulthood. A pediatric bone scan with a value in the lowest quartile had a sensitivity of 48% (95% confidence interval [CI] 27-69%) and a specificity of 76% (95% CI 66-84%) to identify individuals who would remain in the lowest quartile also in adulthood. Childhood forearm BMD explained 12% of the variance in adult BMD in men and 25% in women. A pediatric distal forearm BMD scan has poor ability to predict adult bone mass.
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden, christian.buttazzoni@med.lu.se.
authors.forename: Christian
authors.initials: C
authors.lastname: Buttazzoni
authors.forename: Bjorn E
authors.initials: BE
authors.lastname: Rosengren
authors.forename: Magnus
authors.initials: M
authors.lastname: Tveit
authors.forename: Lennart
authors.initials: L
authors.lastname: Landin
authors.forename: Jan-Åke
authors.initials: JÅ
authors.lastname: Nilsson
authors.forename: Magnus K
authors.initials: MK
authors.lastname: Karlsson
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005260:Female; D005542:Forearm / Q000000981:diagnostic imaging; D005544:Forecasting; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D014457:Ulna / Q000000981:diagnostic imaging